FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2022243114> ?p ?o ?g. }

• W2022243114 endingPage "219" @default.
• W2022243114 startingPage "214" @default.
• W2022243114 abstract "Chemotherapy for neuroendocrine tumors includes treatment with combinations of streptozotocin (STZ) + doxorubicin and/or 5-fluorouracil (5-FU), cisplatin + etoposide and dacarbazine. Recently, some new chemotherapeutic agents have come into use, such as temozolomide, oxaliplatin, and capecitabine, but they will not be discussed here.The decision to give chemotherapy should be based on criteria of primary tumor localization, stage and proliferation index as stated in the ENETS Guidelines. It should be emphasized that administration of chemotherapy may elicit hormonal crises.The combination of STZ + doxorubicin or 5-FU should be given according to the ENETS Guidelines. The main indication for the use of this combination is treatment of malignant inoperable neuroendocrine pancreatic tumors with low to moderate proliferate capacity, when biotherapy has failed. STZ is an alkylating nitrosurea compound, but the exact mechanism of its cytotoxicity is not known. 5-FU acts as an antimetabolite that inhibits thymidylate synthetase, causing depletion of thymidine which results in cell death. Doxorubicin binds to DNA, resulting in steric hindrance of DNA and RNA synthesis. Combination treatment with STZ + 5-FU or doxorubicin may reduce hormonal symptoms and result in an objective tumor response in 20–35% of patients.The patients should be asked about the following symptoms that might influence the decision: fever, cough, dysuria and diarrhea. Certain laboratory tests of blood and urine should be analyzed: blood counts, transaminases, bilirubin, albumin, creatinine clearance and blood glucose. Body weight and blood pressure should also be checked. If doxorubicin is given, the cardiac ejection fraction (EF) should be determined. An EF <40% precludes treatment. For evaluation of the disease, chromogranin A (CgA) and other specific tumor markers should be determined and followed during treatment.The patient information should include description of action, side effects and how to react to adverse effects.Frequent small meals are recommended to maintain adequate nutrition.The following drug interaction should be considered: doxorubicin toxicity may be increased with concurrent use of STZ and the doxorubicin dosage should be adjusted accordingly.In younger patients:Contraception is recommended.Cryoconservation of sperm and tissue of the ovaries should be considered.According to the ENETS Guidelines.In the combination of STZ + 5-FU described by Moertel et al. [1], STZ should be given at 0.5 g/m2 together with 5-FU 400 mg/m2 for 5 days every 6 weeks. STZ is administered as a short (30–60 min) infusion or rapid intravenous push and 5-FU is given as intravenous bolus injection (table 1).When STZ is given in combination with doxorubicin, STZ is administered at 0.5 g/m2 for 5 days every 6 weeks and doxorubicin at 50 mg/m2 on days 1 and 22.Some centers use an alternative schedule: STZ 0.5 g/m2 for 5 days, then repeated as a 1-day treatment 1 g/m2 every 3 weeks. 5-FU is given at 400 mg/m2 days 1–3 during the first course, and then 400 mg/m2 every 3 weeks. When doxorubicin is combined with STZ, doxorubicin at 40 mg/m2 is given on day 1 and then repeated every 3 weeks. In case of reduced creatinine clearance, the 1-day course of STZ can be given over 2 days instead.Premedication with antiemetics, mainly serotonin- receptor blockers, should be used and prehydration with 1–2 liters of fluid is recommended to protect the kidneys.Dose adjustments may be necessary if patients develop severe nausea despite antiemetics, or if impaired renal function occurs.Check for extravasation.Check before every course: creatinine clearance, blood counts, transaminases, bilirubin, albumin, blood glucose. EF checked every 100 mg/m2 of doxorubicin.• Nausea – try another 5-HT3-receptor blocker or add aprepitant.• Renal impairment – dose reductions of STZ should be considered when creatinine clearance is <60 ml/min and should not be given below 30 ml/min.• Liver impairment – reduction of doses should be considered.• Stomatitis – frequent mouth care.• Cardiac toxicity – doxorubicin should be withdrawn.• Photosensitivity – avoid direct sunlight.At a cumulative dose of 550 mg/m2 of doxorubicin, the drug must be stopped. If the patient is still responding, 5-FU may be used instead.Evaluate patients every 3–6 months.• Biochemistry:CgAOther specific markers• Imaging:CT or MRI every 6 monthsUS of the abdomen if indicated every 3 months.Use RECIST or WHO criteria.This combination should be used according to the first edition of the ENETS Guidelines. The main indication for the use of cisplatin + etoposide is treatment of poorly differentiated neuroendocrine tumors. Cisplatin has activities similar to alkylating agents and inhibits the DNA synthesis. Etoposide exerts a cytostatic effect of cells in S- and G2-phase and inhibits mitosis. It also appears to cause DNA strand breaks. The combination has been reported to produce objective responses in about 50% of anaplastic or poorly differentiated neuroendocrine tumors.The patients should be asked about the following symptoms that might influence the decision: fever, cough, dysuria, pain or paresthesia of hands and feet, visual disturbances, headache and diarrhea. In addition, blood cell count, transaminases, bilirubin, blood glucose, serum albumin and creatinine clearance should be analyzed. Blood pressure and body weight should be checked before and during the course. For tumor disease evaluation, CgA and other elevated tumor markers should be determined and followed during treatment.The patient information should include description of mechanisms of action, side effects and how to react to side effects.Against nausea, frequent small meals, sucking lozenges or chewing gum may help.The following drug interactions should be taken into consideration:• Cyclosporine may decrease/increase the levels of etoposide.• CYP3A4 inducers may decrease the levels of etoposide, e.g. carbamazepine, phenytoin, phenobarbital.• CYP3A4 inhibitors may increase the levels of etoposide, e.g. clarithromycin, diclofenac, erythromycin, doxycyclin, imatimib, etc.• Warfarin may elevate prothrombin time with concurrent use.• Concomitant administration of nephrotoxic or ototoxic drug, e.g. aminoglycosides, should be avoided.Pregnancy and Nursing• Contraceptive measures are recommended.• Cryopreservation of sperm and ovarian tissue should be considered.This should be given according to the ENETS Guidelines with the following schedule: etoposide at a dose of 100 mg/m2 for 3 days and cisplatin at a dose of 45 mg/m2 per day on days 2 and 3 by a continuous intravenous infusion in a solution of 5% dextrose and 0.45% saline. On day 1, the daily dose is given in 1,000 ml solution; on days 2 and 3, one-third of the daily dose is given in 1,000 ml solution every 8 h.Alternative regimen: On day 1, the daily dose of etoposide (100 mg/m2) is given in 1,000 ml 5% dextrose solution. On days 2 and 3, hydration with normal saline 1,000 ml with 20 mmol potassium is given over 2 h, followed by cisplatin 45 mg/m2 in 500 ml normal saline (1-hour infusion) in parallel with infusion of mannitol (150 mg/ml) 500 ml. Etoposide (100 mg/m2) is then given (2-hour infusion) in 1,000 ml glucose solution, followed by 1,000 ml of normal saline with 5 mmol magnesium and 20 mmol potassium added (2-hour infusion).For antiemetics, the patient should receive serotonin receptor blockers on days 1–3 and dexamethasone during days 2–3 and 3 days after treatment. The diuresis should be monitored carefully during treatment and furosemide given if the diuresis is lower than 400 ml in 4 h. Extravasation should be checked for. If hypotension occurs, the etoposide infusion should be slowed down.Courses should be repeated every 4 weeks.• Reductions in doses of cisplatin should be made if creatinine clearance is <60 ml/min and stopped if clearance is <30 ml/min.• Because of the high protein binding, the dose of etoposide should be reduced if albumin is <30 g/l or bilirubin >50 µmol/l or INR >1.2.• Nausea and vomiting – aprepitant can be added if this is a problem.• Control of serum creatinine, creatinine clearance and liver function (bilirubin, albumin, INR) should be performed before each course.• Blood counts should be checked every week. Chemotherapy should not be repeated until leukocytes >4 × 109/l, platelets >100 × 109/l and hemoglobin are satisfactory.• Audiometry should be performed before each treatment.• Neurologic examination for peripheral neuropathy, which is dose- and duration-dependent.• Anaphylactic-like reactions should be looked for.• Alopecia – reversible.• Nausea and vomiting – 5-HT3 blockers, dexamethasone and aprepitant should be used.• Hypotension – slow the infusion of etoposide.• Nephrotoxicity; prehydration and maintained diuresis important, furosemide may be used if necessary; body weight should be checked.• Susceptibility to infections – patients should avoid crowds.• Avoid alcohol and aspirin-containing products.• Diarrhea – eat yoghurt or buttermilk.• Stomatitis – frequent mouth care.Evaluate patients every 2–3 months.• Biochemistry:CgA Other elevated tumor marker• Imaging:CT or MR every 2–3 months.Use the RECIST or WHO criteria.Some early publications reported beneficial effects of dacarbazine (DTIC) treatment in patients with malignant abdominal tumors. The main indication could be malignant neuroendocrine pancreatic tumors, when biotherapy and combinations with STZ have failed. DTIC is an alkylating agent that causes cross-links of DNA resulting in the inhibition of DNA, RNA, and protein synthesis. The drug may induce tumor responses in patients with neuroendocrine tumors.The patients should be asked about the presence of fever, cough, dysuria, headache and diarrhea. Basal investigations include blood cell count, transaminases, bilirubin, albumin, blood glucose and creatinine clearance. Blood pressure and body weight should be checked. Biochemical tumor markers, including CgA, should be determined before and followed during treatment.The patient information should include description of mechanisms of action, side effects and how to react to side effects.Since DTIC is extensively metabolized in the liver, it interacts with a number of other drugs.• CYP1A2 inducers may decrease levels/effects of DTIC; examples carbamazepine, phenobarbital.• CYP1A2 inhibitors may increase levels/effects of DTIC; examples ciprofloxacin, ketoconazole, etc.• CYP2E1 inhibitors may increase levels/effects of the drug; examples disulfiram, miconazole.• Vaccines, live virus may cause viral infections in patients receiving DTIC.Patients should limit oral intake for 4–6 h before therapy. They should not use alcohol or aspirin-containing products and should maintain adequate nutrition and hydration during therapy.Pregnancy and Nursing• Contraceptive measures are strongly recommended.• Cryopreservation of sperm and ovarian tissue should be considered.Different schedules have been used. The most commonly used are:• intravenous infusion of 650 mg/m2 over 60–90 min, repeated every 4 weeksor• intravenous infusion of 200–250 mg/m2 over 30–60 min repeated every 3 weeks.DTIC may cause tissue damage. If this occurs, a central line should be used.• Renal impairment requires dose adjustments.• Hepatic impairment should be looked for (and the extremely rare adverse event of liver necrosis due to occlusion of intrahepatic veins).• Myelosuppression may be severe and lead to postponement or withdrawal of treatment.• Nausea and vomiting are very common and can be dose-limiting.• Blood cell count every week.• Liver function before each course (bilirubin, albumin, transaminases).• Creatinine clearance before each course.• Alopecia – reversible.• Nausea and vomiting – 5-HT3-receptor blocker, dexamethasone and aprepitant should be used.• Myelosuppression for neutropenia filgrastrim may be used.• To avoid pain on infusion, a central line should be used.• Photosensitivity – patients should avoid direct exposure to sunlight.• Flu-like syndrome – could last for a week.• Anaphylactic reactions and hepatic necrosis occur in <1% of patients.Evaluate patients every 2–3 months.• Biochemistry:CgAOther tumor markers• Imaging:CT or MRI every 2–3 months.Use the RECIST or WHO criteria.Göran Åkerström, Department of Surgery, University Hospital, Uppsala (Sweden); Rudolf Arnold, Department of Internal Medicine, Philipps University, Munich (Germany); Jaroslava Barkmanova, Department of Oncology, University Hospital, Prague (Czech Republic); Yuan-Jia Chen, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing (China); Frederico Costa, Hospital Sirio Libanes, Centro de Oncologia, São Paulo (Brazil); Anne Couvelard, Service de Gastroentérologie, Hôpital Beaujon, Clichy (France); Joseph Davar, Department of Cardiology, Royal Free Hospital, London (UK); Wouter de Herder, Department of Internal Medicine, Section of Endocrinology, Erasmus MC, Rotterdam (The Netherlands); Gianfranco Delle Fave, Ospedale S. Andrea, Rome (Italy); Massimo Falconi, Medicine and Surgery, University of Verona, Verona (Italy); Diego Ferone, Departments of Internal Medicine and Endocrinological and Metabolic Sciences, University of Genoa, Genoa (Italy); David Gross, Department of Endocrinology and Metabolism, Hadassah University Hospital, Jerusalem (Israel); Ashley Grossman, St. Bartholomew’s Hospital, London (UK); Björn Gustafsson, Medisinsk avd, Gastroseksjon, St Olavs Hospital, Trondheim (Norway); Rudolf Hyrdel, II. Internal Medical Department, University Hospital Martin, Martin (Slovakia); Diana Ivan, Endocrinology and Diabetology, Klinikum der Philipps-Universität, Marburg (Germany); Gregory Kaltsas, G. Genimatas Hospital, Athens (Greece); Reza Kianmanesh, UFR Bichat-Beaujon-Louis Mourier, Service de Chirurgie Digestive, Hôpital Louis Mourier, Colombes (France); Günter Klöppel, Institut für Pathologie, TU München, Munich (Germany); Ulrich-Peter Knigge, Department of Surgery, Rigshospitalet, Copenhagen (Denmark); Paul Komminoth,Institute for Pathology, Stadtspital Triemli, Zürich (Switzerland); Beata Kos-Kudła, Slaska Akademia Medyczna Klinika Endokrynologii, Zabrze (Poland); Dik Kwekkeboom, Department of Nuclear Medicine, Erasmus University Medical Center, Rotterdam (The Netherlands); Rachida Lebtahi, Nuclear Medicine Department, Bichat Hospital, Paris (France); Val Lewington, Royal Marsden, NHS Foundation Trust, Sutton (UK); Anne Marie McNicol, Division of Cancer Sciences and Molecular Pathology, Pathology Department, Royal Infirmary, Glasgow (UK); Ola Nilsson, Department of Pathology, Sahlgrenska sjukhuset, Gothenburg (Sweden); Kjell Öberg, Department of Internal Medicine, Endocrine Unit, University Hospital, Uppsala (Sweden); Juan O’Connor, Instituto Alexander Fleming, Buenos Aires (Argentina); Dermot O’Toole, Department of Gastroenterology and Clinical Medicine, St. James’s Hospital and Trinity College Dublin, Dublin (Ireland); Ulrich-Frank Pape, Department of Internal Medicine, Division of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin (Germany); Mauro Papotti, Department of Biological and Clinical Sciences, University of Turin/St. Luigi Hospital, Turin (Italy); Aurel Perren, Institut für Allgemeine Pathologie und Pathologische Anatomie der Technischen Universität München, Klinikum r.d. Isar, Munich (Germany); Guido Rindi, Department of Pathology and Laboratory Medicine, Università degli Studi, Parma (Italy); Philippe Ruszniewski, Service de Gastroentérologie, Hôpital Beaujon, Clichy (France); Aldo Scarpa, Department of Pathology, University of Verona, Verona (Italy); Kle mens Scheidhauer, Klinikum rechts der Isar, TU München, Munich (Germany); Jean-Yves Scoazec, Anatomie Pathologique, Hôpital Edouard-Herriot, Lyon (France); Anders Sundin, Department of Radiology, Uppsala University Hospital, Uppsala (Sweden); Waldemar Szpak, Westville Hospital, Mayville (South Africa); Babs Taal, Netherlands Cancer Centre, Amsterdam (The Netherlands); Pavel Vitek, Institute of Radiation Oncology, University Hospital, Prague (Czech Republic); Marie-Pierre Vullierme, Service de Gastroentérologie, Hôpital Beaujon, Clichy (France); Bertram Wiedenmann, Department of Internal Medicine, Division of Hepatology and Gastroenterology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin (Germany)." @default.
• W2022243114 created "2016-06-24" @default.
• W2022243114 creator A5001546426 @default.
• W2022243114 creator A5009862688 @default.
• W2022243114 creator A5035175323 @default.
• W2022243114 creator A5035332783 @default.
• W2022243114 creator A5055143638 @default.
• W2022243114 creator A5070704228 @default.
• W2022243114 creator A5078768221 @default.
• W2022243114 creator A5079448077 @default.
• W2022243114 date "2009-01-01" @default.
• W2022243114 modified "2023-10-08" @default.
• W2022243114 title "ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Chemotherapy in Patients with Neuroendocrine Tumors" @default.
• W2022243114 cites W176577999 @default.
• W2022243114 cites W1995681258 @default.
• W2022243114 cites W2031807907 @default.
• W2022243114 cites W2055710544 @default.
• W2022243114 cites W2081457024 @default.
• W2022243114 cites W2339290868 @default.
• W2022243114 doi "https://doi.org/10.1159/000225950" @default.
• W2022243114 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/19713713" @default.
• W2022243114 hasPublicationYear "2009" @default.
• W2022243114 type Work @default.
• W2022243114 sameAs 2022243114 @default.
• W2022243114 citedByCount "86" @default.
• W2022243114 countsByYear W20222431142012 @default.
• W2022243114 countsByYear W20222431142013 @default.
• W2022243114 countsByYear W20222431142014 @default.
• W2022243114 countsByYear W20222431142015 @default.
• W2022243114 countsByYear W20222431142016 @default.
• W2022243114 countsByYear W20222431142017 @default.
• W2022243114 countsByYear W20222431142018 @default.
• W2022243114 countsByYear W20222431142019 @default.
• W2022243114 countsByYear W20222431142020 @default.
• W2022243114 countsByYear W20222431142021 @default.
• W2022243114 countsByYear W20222431142022 @default.
• W2022243114 countsByYear W20222431142023 @default.
• W2022243114 crossrefType "journal-article" @default.
• W2022243114 hasAuthorship W2022243114A5001546426 @default.
• W2022243114 hasAuthorship W2022243114A5009862688 @default.
• W2022243114 hasAuthorship W2022243114A5035175323 @default.
• W2022243114 hasAuthorship W2022243114A5035332783 @default.
• W2022243114 hasAuthorship W2022243114A5055143638 @default.
• W2022243114 hasAuthorship W2022243114A5070704228 @default.
• W2022243114 hasAuthorship W2022243114A5078768221 @default.
• W2022243114 hasAuthorship W2022243114A5079448077 @default.
• W2022243114 hasConcept C126322002 @default.
• W2022243114 hasConcept C134018914 @default.
• W2022243114 hasConcept C143998085 @default.
• W2022243114 hasConcept C204232928 @default.
• W2022243114 hasConcept C2776694085 @default.
• W2022243114 hasConcept C2779066768 @default.
• W2022243114 hasConcept C2993769353 @default.
• W2022243114 hasConcept C3020482125 @default.
• W2022243114 hasConcept C71924100 @default.
• W2022243114 hasConceptScore W2022243114C126322002 @default.
• W2022243114 hasConceptScore W2022243114C134018914 @default.
• W2022243114 hasConceptScore W2022243114C143998085 @default.
• W2022243114 hasConceptScore W2022243114C204232928 @default.
• W2022243114 hasConceptScore W2022243114C2776694085 @default.
• W2022243114 hasConceptScore W2022243114C2779066768 @default.
• W2022243114 hasConceptScore W2022243114C2993769353 @default.
• W2022243114 hasConceptScore W2022243114C3020482125 @default.
• W2022243114 hasConceptScore W2022243114C71924100 @default.
• W2022243114 hasIssue "2" @default.
• W2022243114 hasLocation W20222431141 @default.
• W2022243114 hasLocation W20222431142 @default.
• W2022243114 hasOpenAccess W2022243114 @default.
• W2022243114 hasPrimaryLocation W20222431141 @default.
• W2022243114 hasRelatedWork W1966504330 @default.
• W2022243114 hasRelatedWork W1966775726 @default.
• W2022243114 hasRelatedWork W1979139803 @default.
• W2022243114 hasRelatedWork W2030889776 @default.
• W2022243114 hasRelatedWork W2037631372 @default.
• W2022243114 hasRelatedWork W2040058909 @default.
• W2022243114 hasRelatedWork W2132898409 @default.
• W2022243114 hasRelatedWork W2748952813 @default.
• W2022243114 hasRelatedWork W2887754102 @default.
• W2022243114 hasRelatedWork W4249176446 @default.
• W2022243114 hasVolume "90" @default.
• W2022243114 isParatext "false" @default.
• W2022243114 isRetracted "false" @default.
• W2022243114 magId "2022243114" @default.
• W2022243114 workType "article" @default.